Background Chronic heart failure is one of the main cardiovascular diseases that has increased prevalence in the recent years and it has been projected that chronic heart failure will be a major cause of morbidity and mortality in the future. Recent researches demonstrate the importance of certain trace elements in the pathogenesis of cardiovascular disorders. Among these elements is copper metal. It is considered as a strong antioxidant. Objectives This study was undertaken in order to investigate the serum copper level in patients with chronic heart failure compared to healthy individuals, and to find whether there is any relationship between serum copper level and patients with chronic heart failure. Patients and methods A case series study was conducted on 53 patients (37 males, 16 females) with chronic heart failure, with a mean age of 52.23+ 13.1 years who randomly selected from patients admitted to medical wards and Cardiac Care Unit of Ibin-Seena Teaching Hospital in Mosul city during the period from July 2006 to December 2006. The study also included 32 healthy volunteers (18 males, 14 females) with a mean age of 41.31+ 14.72 years, as a control group. Serum copper concentration was measured in patients with chronic heart failure and healthy controls. Results The results indicate that patients exhibited significant decrease in the serum copper level (p<0.001) as compared to the healthy controls. Also the results showed that there is no statistically significant difference in the concentration of serum copper between males and females in patients with chronic heart failure (p>0.05). Conclusions and Recommendations Chronic heart failure is a multifactorial syndrome. Several factors had been found to contribute to the development of this syndrome. Low serum copper level may be one of these contributing factors, probably by elevating blood pressure, impairing different tissue formation and inducing high serum cholesterol level. Measurement of serum copper level might provide additional and useful laboratory test for the assessment of the patients with chronic heart failure and oral copper may have a role in therapy.